When professionals are first learning about The HUG, it is sometimes difficult for them to imagine how to integrate the HUG Strategies and other resources into their practice. Nurses, doctors and doulas tell me they already have too much to accomplish in too little time! I certainly can appreciate this feeling of being pressed for time; however, as new learners become more comfortable with The HUG Strategies, they may find (as I have) that opportunities frequently arise for applying The HUG in the natural course of a work day. Here is just such a serendipitous HUG moment:

Claire, the medical student spending time at the pediatrics practice where I work, asked me to show her how to swaddle an infant. We practiced on a stuffed animal and talked about effective strategies for supporting an overstimulated infant and the safest way to swaddle: allowing the baby's hips to flex and avoiding overheating. We had just finished this short teaching session, and were walking down the hall, when we saw two-week-old Jason being checked in for a visit, along with his mom and grandmother.

I noticed that Jason was none too happy about being weighed. I “gazed” at mom, whose wrinkled brow and anxious face signaled that she was equally uncomfortable with her new baby lying there, uncovered and fussing. Grandmother wondered aloud how long the staff was going to leave poor Jason exposed in the cool room. The stress on both mother’s and grandmother’s faces told me that now was a good time to implement the “Gaze, then Engage” HUG Strategy. I “engaged” with mom by acknowledging that it is always upsetting to see a baby fuss a few minutes. I then asked her permission to demonstrate swaddling her baby for Claire. Mom agreed, and was eager for me to show her as well.

As the nurse lifted Jason off the scale and placed him on the measuring table, he showed us an SOS (Sign of Over-Stimulation) from being awakened, undressed, and now a little cold. Mom and grandma watched intently as I "broadcasted" his pale color, furrowed brow and jerky movements, and then "commentated" that these SOSs are one way babies communicate with us, even without crying. I swaddled Jason's upper body in two easy tucks of the blanket and explained the importance of leaving the blanket loosely wrapped around his hips and legs. In the wink of an eye I was able to “broadcast” that Jason was now still; his cheeks were pink; his eyes were wide, and he looked right at my face.

Everyone smiled in a shared "Ah Hah" moment. I “commentated” about the changes we all just saw by explaining that some babies need help controlling their motor activity before they can calm down. With a little help, Jason had just moved from the Rebooting Zone to the Ready Zone -- ready to play, ready to eat, or ready to have his check-up. Mom said, "I can’t wait to share this with my husband. I had a C-section, so Jason's dad has been doing most of his care." The experienced nurse looking over my shoulder joined in, "Thanks! I never knew how to do that!"

By applying the strategy of Gaze, Then Engage, in just a couple of minutes, one baby, two family members, and two professionals got The HUG. And Jason, his mom and grandma were all off to the exam room, right on time, for his check-up.

"I want to be a good mom!"

Issues of Confidentiality

Specific names and circumstances in this blog are fictional. .

Jan Tedder, BSN, FNP, IBCLC

Jan Tedder, BSN, IBCLC, Family Nurse Practitioner

Jan has worked in a primary care setting with babies and their families for thirty years. A graduate of UNC Charolotte and Chapel Hill, she has lectured at both national and international conferences. She has been honored as the NC Maternal Child Health Nurse of the Year. Her website, DVD, and online training are winners of the 2007 and 2009 National Health and WWW Awards.